| NPI | 1093277022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.146393) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.247809) |
| 261QS1000X Clinic/Center, Student Health | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2023-11-03 |